What does the health care law mean for you?

June 29, 2012

WASHINGTON - Free vaccines for kids, cheaper drugs for the elderly and many other benefits of President Barack Obama's health care law are already out there. More are coming, like a guaranteed right to buy health insurance even for patients with serious medical troubles. Many businesses and wealthy taxpayers, however, will see their costs go up.

And most Americans balk at the idea of the government making people carry insurance or pay a penalty on their federal tax returns.

The effects of the nation's health care law, upheld Thursday by the Supreme Court, are gigantic and growing. Some questions and answers about it:

Q: What does the ruling mean for me?

A: The ruling affects virtually every American. Obama's health care law tells almost everyone they must be insured and makes sure that coverage will be available to them even if they are already ill or need hugely expensive care. It helps the poor and many middle-class people afford the cost. And it requires insurers to provide certain basic benefits, like preventive care without co-pays from the patient.

Q: What did the Supreme Court say?

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A: The court upheld almost all of the law, including the most disputed part: the requirement that virtually all Americans have health insurance or pay a penalty. The court said the penalty is essentially a tax, and that's why the government has the power to impose it.

The ruling somewhat limits the plan to expand the Medicaid insurance program for the poor, a joint effort of the federal government and states. It says the government may not withhold a state's entire Medicaid allotment if it doesn't participate in the expansion.

A: It's a big win for Obama, dousing accusations that his signature legislation was an unconstitutional power grab. But Republicans hope the court's ruling will fire up their supporters and inflame popular opposition to the law.

Presumptive Republican presidential nominee Mitt Romney and GOP congressional candidates promise to repeal the law if voters put them in power.

Q: What's the law done so far?

A: Some parts, like the elimination of co-payments for preventive care, are already in effect. Young adults can stay on their parents' insurance up to age 26. Insurers can't deny coverage to children with health problems. Limits on how much policies will pay out to each person over a lifetime are eliminated. And hundreds of older people already are saving money through improved Medicare prescription benefits.

Q: What else is coming?

A: Unless Congress changes the law, starting in 2014 almost everyone will be required to be insured or pay a penalty. Subsidies will help people who can't afford coverage. Most employers will face fines if they don't offer coverage for their workers. Newly created insurance markets will make it easier for individuals and small businesses to buy affordable coverage. And Medicaid will be expanded to cover more low-income people.

Insurers will be prohibited from denying coverage to people with medical problems or charging those people more. They won't be able to charge women more than men, either. During the transition to 2014, a special program for people with pre-existing health problems helps these people get coverage.

The law is expected to bring coverage to about 30 million of the estimated 50 million uninsured people in the U.S.

Overall, more than 9 in 10 of the eligible population - citizens and legal residents - will be covered.

Q: Why will some people still go without insurance?

A: It's estimated that more than 20 million people will still be without coverage, including illegal immigrants, people who don't sign up and choose to face the penalties instead and those who can't afford coverage even with the subsidies. That number could be higher, depending on whether any states decline the Medicaid expansion.